Age-related hearing loss accelerates the decline in fast speech comprehension and the decompensation of cortical network connections

Patients with age-related hearing loss face hearing difficulties in daily life.The causes of age-related hearing loss are complex and include changes in peripheral hearing,central processing,and cognitive-related abilities.Furthermore,the factors by which aging relates to hearing loss via changes in audito ry processing ability are still unclear.In this cross-sectional study,we evaluated 27 older adults(over 60 years old) with age-related hearing loss,21 older adults(over 60years old) with normal hearing,and 30 younger subjects(18-30 years old) with normal hearing.We used the outcome of the uppe r-threshold test,including the time-compressed thres h old and the speech recognition threshold in noisy conditions,as a behavioral indicator of auditory processing ability.We also used electroencephalogra p hy to identify presbycusis-related abnormalities in the brain while the participants were in a spontaneous resting state.The timecompressed threshold and speech recognition threshold data indicated significant diffe rences among the groups.In patients with age-related hearing loss,information masking(babble noise) had a greater effect than energy masking(speech-shaped noise) on processing difficulties.In terms of resting-state electroencephalography signals,we observed enhanced fro ntal lobe(Brodmann’s area,BA11) activation in the older adults with normal hearing compared with the younger participants with normal hearing,and greater activation in the parietal(BA7) and occipital(BA19) lobes in the individuals with age-related hearing loss compared with the younger adults.Our functional connection analysis suggested that compared with younger people,the older adults with normal hearing exhibited enhanced connections among networks,including the default mode network,sensorimotor network,cingulo-opercular network,occipital network,and frontoparietal network.These results suggest that both normal aging and the development of age-related hearing loss have a negative effect on advanced audito ry processing capabilities and that hearing loss accele rates the decline in speech comprehension,especially in speech competition situations.Older adults with normal hearing may have increased compensatory attentional resource recruitment represented by the to p-down active listening mechanism,while those with age-related hearing loss exhibit decompensation of network connections involving multisensory integration.

Biological,pathological,and multifaceted therapeutic functions of exosomes to target cancer

Exosomes,small tiny vesicle contains a large number of intracellular particles that employ to cause various diseases and prevent several pathological events as well in the human body.It is considered a“double-edged sword”,and depending on its biological source,the action of exosomes varies under physiological conditions.Also,the isolation and characterization of the exosomes should be performed accurately and the methodology also will vary depending on the exosome source.Moreover,the uptake of exosomes from the recipients’cells is a vital and initial step for all the physiological actions.There are different mechanisms present in the exosomes’cellular uptake to deliver their cargo to acceptor cells.Once the exosomal uptake takes place,it releases the intracellular particles that leads to activate the physiological response.Even though exosomes have lavish functions,there are some challenges associated with every step of their preparation to bring potential therapeutic efficacy.So,overcoming the pitfalls would give a desired quantity of exosomes with high purity.

Small molecule inhibitor DDQ-treated hippocampal neuronal cells show improved neurite outgrowth and synaptic branching

The process of neurite outgrowth and branching is a crucial aspect of neuronal development and regeneration.Axons and dendrites,sometimes referred to as neurites,are extensions of a neuron's cellular body that are used to start networks.Here we explored the effects of diethyl(3,4-dihydroxyphenethylamino)(quinolin-4-yl)methylphosphonate(DDQ)on neurite developmental features in HT22 neuronal cells.In this work,we examined the protective effects of DDQ on neuronal processes and synaptic outgrowth in differentiated HT22cells expressing mutant Tau(mTau)cDNA.To investigate DDQ chara cteristics,cell viability,biochemical,molecular,western blotting,and immunocytochemistry were used.Neurite outgrowth is evaluated through the segmentation and measurement of neural processes.These neural processes can be seen and measured with a fluorescence microscope by manually tracing and measuring the length of the neurite growth.These neuronal processes can be observed and quantified with a fluorescent microscope by manually tracing and measuring the length of the neuronal HT22.DDQ-treated mTau-HT22 cells(HT22 cells transfected with cDNA mutant Tau)were seen to display increased levels of synaptophysin,MAP-2,andβ-tubulin.Additionally,we confirmed and noted reduced levels of both total and p-Tau,as well as elevated levels of microtubule-associated protein 2,β-tubulin,synaptophysin,vesicular acetylcholine transporter,and the mitochondrial biogenesis protein-pe roxisome prolife rator-activated receptor-gamma coactivator-1α.In mTa u-expressed HT22 neurons,we observed DDQ enhanced the neurite characteristics and improved neurite development through increased synaptic outgrowth.Our findings conclude that mTa u-HT22(Alzheimer's disease)cells treated with DDQ have functional neurite developmental chara cteristics.The key finding is that,in mTa u-HT22 cells,DDQ preserves neuronal structure and may even enhance nerve development function with mTa u inhibition.

Treatment of laryngopharyngeal reflux disease: A systematic review

BACKGROUNG For a long time,laryngopharyngeal reflux disease(LPRD)has been treated by proton pump inhibitors(PPIs)with an uncertain success rate.AIM To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.METHODS Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD.Clinical prospective or retrospective studies had to explore the impact of medical treatment(s)on the clinical presentation of suspected or confirmed LPRD.The criteria for considering studies for the review were based on the population,intervention,comparison,and outcome framework.RESULTS The search identified 1355 relevant papers,of which 76 studies met the inclusion criteria,accounting for 6457 patients.A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring(MII-pH).The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk.The most used PPIs were omeprazole,esomeprazole,rabeprazole,lansoprazole and pantoprazole with a success rate ranging from 18%to 87%.Other composite treatments have been prescribed including PPIs,alginate,prokinetics,and H2 Receptor antagonists.CONCLUSION Regarding the development of MII-pH and the identification of LPRD subtypes(acid,nonacid,mixed),future studies are needed to improve the LPRD treatment considering all subtypes of reflux.

Gain adjustment at tinnitus pitch to manage both tinnitus and speech perception in noise

To investigate how much gain variation is required from prescription to effect tinnitus percept,and if this revised prescription affects speech recognition.Twenty participants who experienced catastrophic tinnitus even after fitted with hearing aid were included.Participants were grouped based on their tinnitus pitch and the prescriptive formula used to fit hearing aid.They were evaluated for handicap from tinnitus using Tinnitus Handicap Inventory(THI).Hearing aid was programmed using either NAL-NL2 or DSL(I/o)v5 prescriptive formula and gain at tinnitus pitch was adjusted till the tinnitus get suppressed.SNR 50 was determined soon after fitted with hearing aid and 30 days of hearing aid use.Further,THI and international outcome inventory for hearing aid(IOI-HA)were determined after 30 days of hearing aid use.A significant higher gain adjustment was needed at tinnitus pitch to reduce tinnitus precept using NAL-NL2 than DSL(I/o)v5 prescriptive formula.Further,SNR 50 was not affected by either tinnitus pitch or revised prescription formulas.However,SNR 50 improved after 30 days of hearing aid use.A 76% of the participants’experienced habituation to perception after 30 days of hearing aid use,10% had slight,10% had mild,and 4% had a moderate degree of tinnitus on THI.On IOA-HA,96%(N=19)of participants have reported satisfactory,and 4%(N=1)reported moderate benefit from hearing aid.Irrespective of prescriptive formula adjusting gain at tinnitus pitch is an efficient method to reduce tinnitus symptoms and improve speech perception.

Knowledge, attitude, and practice of techniques of breastfeeding among new mothers: A survey across Delhi Region

Objective:The present study aims to evaluate aims to assess the knowledge,attitude,and practice of primiparous mothers in the immediate postpartum period regarding breastfeeding techniques which will be helpful in forming awareness and training programs.Materials and Methods:A cross-sectional survey was used.A total of 120 primiparous mothers with a mean age of 24.92 years participated in the survey and filled the questionnaire related to the knowledge,attitude,and practice of techniques of breastfeeding.Results:Results revealed that 48.3%of new mothers were not aware of the correct techniques to initiate breastfeeding,whereas 68.3%of subjects reported that during latching,the baby’s upper and lower lip should be everted.The majority of new mothers were aware of breastfeeding techniques with some misconceptions as in our culture,most of the breastfeeding information passed from generation to generation.Conclusion:The level of awareness about feeding skills among primiparous mothers can be further improved by antenatal counseling or training from health-care workers during the gestational period.This will further help new mothers to educate and will provide adequate information which will decrease the myths.

A Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index Results of the Greek Voice-Disordered Patients

Objective(s): The cutting-edge assessment of voice disorders includes objective and subjective methods in the daily clinical practice. The latter assessment is usually performed through the administration of self-reported questionnaires. Voice Handicap Index (VHI) is one of the most widely used tools both in clinical practice and in research level. This tool-questionnaire was employed in this research along with the Voice Evaluation Template (VEF). In turn, the aim of this study was to analyse and produce the cut-off points of VHI for voice-disordered patients in Greece by using Receiver Operating Characteristic Curves (ROC Curves). Methods: Sixty-three participants (40 non-dysphonic and 23 with different types of dysphonia) were classified by ENT (Ear, Nose, and Throat) doctors and SLPs (Speech-Language Pathologists). The Hellenic VHI along with the translated Greek version of the VEF was administered to the subjects of this research. Results: The voice-disordered subjects exhibited higher overall VHI scores (in total and in its 3 subdomains) compared to the control group. Statistical significant differences were found between dysphonic and non-dysphonic participants for all VHI’s construct domains. The cut-off point of VHI total score was estimated at the value of 14.50 (sensitivity: 0.870, 1-specificity: 0.000). Moreover, the cut-off points of the three subdomains were computed as 7.50 for functional (sensitivity: 0.783, 1-specificity: 0.000), 8.50 for physical (sensitivity: 0.739, 1-specificity: 0.000) and 8.50 for emotional domain (sensitivity: 0.783, 1-specificity: 0.050). Conclusion: The preliminary statistical and ROC data analysis of VHI concluded that by using this type of assessment method, populations with or without voice disorders (in Greece) can be distinguished. Albeit this tool is a non-interventional method it could consequently offer an adequate screening and monitoring capability.

Reduced Ecological Footprints of Modern Facilities Introducing the Implementation of Advanced Wireless Technologies, and Human Resources’ Benefits

The necessity of lowering the mean power consumption of various facilities, due to the lack of their enormous future energy needs, led to an ongoing advance of various technologies. These technologies have been oriented towards the concept of a Reduced Ecological Footprint. Massive structures (such as building complexes and hospitals) have been redesigned and upgraded;many interior designs have been dramatically altered while new electronic devices are constantly being produced in order to revolutionize a long term perspective towards a “Green Planet” while they exhibit astonishing signal processing. Consequently, an enormous technology already exists which needs to be properly combined to a proposed methodology and to new ideas relevant to systems’ administration through automatic wireless control. This paper intends to reduce the gap between design and realization of the aforementioned research. Consequently, the primary contribution of this research is the proposal of a complete design protocol with minimized defects relevant to Reduced Ecological Footprints of Facilities (REFF) along with its beneficial advantages relevant to providing a healthy and productive work environment. This protocol consists of four main parts which are 1) the main key points-guidelines, 2) its objectives, 3) the know-how methodology for implementation in existing installations and 4) the description of the imminent benefits in workforce/human resources.

Evaluation of auditory working memory in Bharatanatyam dancers

Background:Neuroplasticity is a phenomenon exhibited by our nervous system as an indicator of overall development and in response to training,injury/loss of particular function,treatment/drugs and as a result of stimulation from the surrounding environment.Objective:The aim of the current study was to assess the auditory working memory capacities in Bharatanatyam dancers.Method:The participants comprised fifty-four females with normal hearing sensitivity who belonged to two groups.Group-I consisted of 27 individuals who underwent formal training in Bharatanatyam for a minimum period of three years.Group-II consisted of the age-matched control group,consisting of 27individuals who were non-dancers.The auditory working memory tasks included arranging the English digits presented binaurally in forward,backward,ascending,and descending spans.The maximum values(for the length of sequence arranged),midpoint values(average score),and response time for each task were noted down and compared among groups.Results:The scores were compared using the Mann-Whitney U test,which revealed enhanced working memory exhibited by dancers for maximum values and midpoint scores for all three tasks except ascending span.It was also noted that the dancers exhibited a shorter response time compared to nondancers for all the tasks except ascending span.Conclusion:The current study highlights an enhanced auditory working memory capacity in Bharatanatyam dancers,which could be perceived as evidence of neuroplastic changes induced in the auditory and motor cortex as a consequence of extensive stimulation for auditory processing abilities and motor planning resulting from long-term dance training and regular practice.

Self-reported participation restrictions in normal hearing individuals in thyroid ontogeny: Evidence of subclinical changes

Purpose: To verify evidence of subclinical alterations through self-reported participation restrictions in normal hearing individuals and congenital hypothyroidism patients.Methods: An analytical, quantitative, cross-sectional exploratory study with a 1:1 ratio, consisting of a convenience sample of 86 normal hearing individuals with(n = 42) and without(n = 44) congenital hypothyroidism diagnosis. All participants underwent tonal and speech audiometry, immitance and distortion product otoacoustic emissions. The researchers excluded people with hearing loss, genetic syndromes and metabolic diseases. The instrument used for evaluate of self-reported participation restrictions was the HHIE-adapted questionnaire, composed of 25 questions, 12 of which were social domain and 13 emotional domain. Student's ttest and chi-square test were used for statistical analysis at a significance level of 5%.Results: There was a significant(p < 0.001) self-reported participation restrictions in CH(61.9%), with a greater relevance for the social domain(p = 0.002). There was a greater frequency of mild/moderate(40.5%)and higher prevalence of association with clinical factors and adherence to treatment.Conclusion: The findings indicate that self-reported participation restrictions in normal hearing individuals with congenital hypothyroidism was more significant than in the non-exposed group, suggesting evidence of subclinical auditory abnormalities in this population.

Preliminary evidence of discourse improvement with dopaminergic medication

Dopaminergic therapy can improve motor functioning in Parkinson’s disease (PD), but its effect on spoken discourse is poorly understood. This study addressed whether discourse produced during a one-minute monologue would be affected by medication withdrawal. We performed a detailed analysis of semistructured speech samples in 38 patients with PD, including measures of efficiency, syntactic complexity, cohesion (i.e., lexical and grammatical ties between sentences), and coherence (i.e., semantic relationship between the utterances and the topic, or between utterances). We found that patients produced more efficient and coherent monlogues when on versus off medication. As discourse relies heavily on cognitive processes such as working memory, these findings are consistent with research showing improved working memory and executive processes with dopaminegic medication.

Can language acquisition be facilitated in cochlear implanted children? Comparison of cognitive and behavioral psychologists' viewpoints

AIM To study how language acquisition can be facilitated for cochlear implanted children based on cognitive and behavioral psychology viewpoints?METHODS To accomplish this objective, literature related to behaviorist and cognitive psychology prospects about language acquisition were studied and some relevant books as well as Medline, Cochrane Library, Google scholar, ISI web of knowledge and Scopus databases were searched. Among 25 articles that were selected, only 11 met the inclusion criteria and were included in the study. Based on the inclusion criteria, review articles, expert opinion studies, non-experimental and experimental studies that clearly focused on behavioral and cognitive factors affecting language acquisition in children were selected. Finally, the selected articles were appraised according to guidelines of appraisal of medical studies.RESULTS Due to the importance of the cochlear implanted child's language performance, the comparison of behaviorist and cognitive psychology points of view in child language acquisition was done. Since each theoretical basis, has its own positive effects on language, and since the two are not in opposition to one another, it canbe said that a set of behavioral and cognitive factors might facilitate the process of language acquisition in children. Behavioral psychologists believe that repetition, as well as immediate reinforcement of child's language behavior help him easily acquire the language during a language intervention program, while cognitive psychologists emphasize on the relationship between information processing, memory improvement through repetitively using words along with "associated" pictures and objects, motor development and language acquisition. CONCLUSION It is recommended to use a combined approach based on both theoretical frameworks while planning a language intervention program.

The Influence of Behavioral and Psychological Symptoms of Dementia on the Autonomic Nervous System

Stress is one of the most potent of many factors that can cause expression of behavioral and psychological symptoms of dementia (BPSD). Stress can also increase autonomic nervous activity. This study aimed to examine the relationships between BPSD and autonomic function in the elderly with dementia. We recruited 35 participants diagnosed with dementia from nearby geriatric health service facilities. The Neuropsychiatric Inventory was used for the evaluation of BPSD, and a TAS 9 VIEW (manufactured by YKC) was used for the heart rate variability analysis to measure autonomic nervous system activity. We constructed a model in which the autonomic nervous system comprised a category and performed a structural equation modeling analysis to calculate the standardization coefficient and correlation coefficient for each factor. The results showed that the influence of BPSD resulted in suppression of sympathetic and enhancement of parasympathetic nervous system activity.

A Comparison of Rey-Osterrieth Complex Figure Test Scores: With/Without Mouthpiece and with/without Noise

In the present study, the ROCF test was initially conducted involving 30 healthy young individuals, in a quiet environment as Experiment 1 to examine variations in the score among different methods to memorize the figure. In such an environment, no significant differences were observed in the score between the copying and outer speech groups, which suggested the possibility of some of the former groups having used outer speech in a voice too low to be heard or moving their lips without vocalization, achieving the same effect as outer speech, and consequently leading to the absence of differences from the outer speech group. On the other hand, the score markedly varied between the mouthpiece and copying or outer speech groups. As lip movements were suppressed in the former case, the unconscious use of outer speech was also prevented, possibly leading to poor results. Based on these findings, it may be possible to enhance the effects of rehabilitation in a clinical setting by promoting patients’ memorization using outer speech to vocalize the contents of training.

Head Position of Patients with Right Hemisphere Damage during a Visual Search Task in a Large Field

Spatial neglect syndrome with cerebral lesions is characterized by the ina-bility to orient, report, or respond to relevant visual stimuli contralateral to the lesions. In this study, we investigated the pattern of horizontal visual search in a large space;this search was performed by patients with right hemisphere damage caused by cerebrovascular disease. The neck rotation angle and search time in each increment were continuously recorded during the task, and quantitative data of the measurements were collected. Head position during the visual search task in a large space (%) was then calculated. We set angular bands in increments of 5 degrees from the midline on the left and right sides, and calculated the total search time in each angular band. In patients with unilateral spatial neglect (USN), the search time in the angular band of 5 - 9 on the right side was significantly longer (with USN 16.7%, without USN 4.5%, t = 2.52, df = 16, p < 0.05). Furthermore, in patients with neglect in the leftmost end area in a large space, the search time was significantly shorter in the angular band of 1 - 4 degrees to the left (with neglect 13.1%, without neglect 23.7%, t = 2.13, df = 16, p < 0.05), and tended to be long in the angular band of 5 - 9 to the right. The neck rotation angle and pattern during the search task in a large field deviated slightly to the right, and the search time slightly to the left was short. We believe that these results support the rightward deviation of the search pattern and frame of USN patients.

Association of Oral Diadochokinesis, Physical Function and Swallowing Function in Community-Dwelling Elderly People

Objective: Oral diadochokinesis (ODK) has been shown to be associated with oral frailty. In this study, we investigate the relationship between physical function, swallowing function, nutritional evaluation, and each syllable of ODK. Methods: The subjects are 26 elderly people living in an area where they can walk. ODK, tongue pressure, modified water swallowing test, EAT-10, grip strength, MNA-SF, skeletal muscle index, height, weight, and BMI were evaluated. For statistical analysis based on ODK values, the subjects were divided into two groups on the basis of the number of times the syllables /pa/, /ta/, and /ka/ were repeated: 1) The first group with >6 repetitions exceeded six; 2) the second group with ≤5 repetitions. Both groups were compared using the Mann-Whitney U test (Model 1). In addition, the syllables /pa/, /ta/, and /ka/ were also divided among the groups and a comparison was performed (Model 2). Results: In Model 1, the tongue pressure value was significantly higher in the good group (p < 0.01). In Model 2, the good group showed significantly higher values for the syllables /pa/ (p < 0.01) and /ta/ (p < 0.05). There was no significant difference in the values for the syllable /ka/. Conclusion: In community-dwelling elderly people, tongue pressure was positively associated with ODK values for the syllables /pa/ and /ta/, suggesting that tongue pressure may be associated with strength of the lip and tongue tip muscles. Furthermore, it was suggested that the ODK values may even be lower than normal values in the elderly who maintain skeletal muscle mass and thus have adequate tongue pressure;therefore, these indicators may be used as a guideline to assess oral frailty.

Effects of Image Presentation Using a Head-Mounted Display on Muscle and Brain Activity during Swallowing

Introduction: It is well known that humans have an increased sense of taste and consume more food when eating with others. This effect is called social facilitation of eating. We previously reported that self-images also have the effect of social facilitation of eating. In the present study, we investigated the effect of a head-mounted display (HMD) as a means of presenting self-images. Methods: Fourteen healthy adults (7 females and 7 males) were included in the study. The mean age of the participants was 20.4 years. The experimental conditions were as follows: the presentation conditions include the SG condition, in which an image was projected on the smart glasses, and the MT condition, in which an image was projected on the monitor. The stimulation conditions include the self-image condition (Self condition), in which the participant’s own image was projected, and the background image condition (Background condition), in which the background image was projected. Participants were asked to consume green tea jelly three times under the four conditions, which consisted of combinations of the presentation and stimulation conditions. Electromyography (EMG) and electroencephalography (EEG) were used to measure the muscle activity of the suprahyoid muscle group and brain activity, respectively. Results: The EMG of the “SG-Self” condition was significantly higher than that of “SG-Background” and “MT-Background” conditions. The EMG of the “MT-Self” condition was significantly higher than that of the “MT-Background” condition. In the EEG before the start of swallowing, “SG-Self” was significantly lower in the alpha band and higher in the beta band than “MT-Background”. The beta-alpha ratio was significantly higher for “SG-Self” than for “SG-Background” and “MT-Background” and higher for “MT-Self” than for “MT-Background”. Conclusion: These results suggest that self-images influence muscle and brain activities during swallowing, regardless of the presentation conditions, such as HMD or monitor.

Incidence and Predictors of Dysphagia Following Anterior Cervical Discectomy and Fusion: Prospective Observational Study

The incidence of dysphagia following anterior cervical discectomy and fusion (ACDF) reported in the literature varies due to differences in measures and time intervals applied, ranging from nearly 3/4 at 2 weeks to 13% at 12 months. The most commonly used dysphagia scales remain subjective, non-validated, and do not capture functional impact. Various risk factors have been identified, though few consistently reproduced and none studied in an Australasian context. The aims of this study were to use objective and validated measures, assess both traditional and novel risk factors, and determine the impact of dysphagia on dietary status, length of stay and complications. METHODS: Twenty-nine adults undergoing ACDF for degenerative pathologies were enrolled between March and November 2015 in an Australian institution. Bazaz dysphagia scale, Dysphagia short questionnaire, 3-ounce swallow test and dietary status were assessed preoperatively, and 2 days and 6 weeks postoperatively. Descriptive statistics were used to characterise the study sample and logistic regression modelling performed on risk factors. RESULTS: Dysphagia incidence ranged from 85% on day-2 Dysphagia short questionnaire to zero on 6-week 3-ounce swallow. All measures increased at 2 days and fell by 6 weeks. Failing day-2 3-ounce swallow was the only measure associated with modifications in solids (P = 0.06), showing significant linear correlation (P = 0.02). Respiratory comorbidity increased risk of failing day-2 3-ounce swallow by more than 32-fold (OR: 32.4;95% CI: 1.8 - 587.7;P = 0.019) and scoring moderate or severe on Bazaz by almost 10-times (OR: 9.3;95% CI: 0.9 - 95.95;P = 0.061). Psychiatric history also increased risk of failing day-2 3-ounce swallow by more than 10-fold (OR: 10.9;95% CI: 1 - 123.7;P = 0.054). Failing 3-ounce swallow increased length of stay (5 versus 7 days;P = 0.013). CONCLUSIONS: Incidence of dysphagia following ACDF was dependent on the measure used, though all improved over time. The 3-ounce swallow test correlated with dietary modification and length of stay, while respiratory comorbidity posed the most significant risk. This may identify a group of patients who may benefit from early intervention.

Differences of Neglect in Peripersonal Space and Extrapersonal Space in a Patient with Unilateral Spatial Neglect

Unilateral spatial neglect (USN) is characterized by neglect in peripersonal and extrapersonal space, the disparity of which is unknown. We assessed these forms of neglect in a patient with USN. We promoted sight scanning in extrapersonal space and used an eye camera to measure gaze movement. We found left-sided sight scanning in peripersonal space, but right-side-biased sight scanning in extrapersonal space. Additionally, line of sight was corrected when the patient was instructed to look left in extrapersonal space and to focus the line of sight at the center. Gaze measurement thus helped to assess disparities in spatial neglect in USN.

Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index of Laryngeal Inflammation in Greek Patients

Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022);physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000);emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.